Volunteer Facilitator Application
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District Of Columbia
Northern Mariana Islands
Are you or have you been a Willow House Family Member? (i.e. have you attended / signed up for group support services?)
Current Job Description
Please list your previous volunteer experience
Type of Volunteer Work (1)
Type of Volunteer Work (2)
Type of Volunteer Work (3)
Type of Volunteer Work (4)
Volunteer with Willow House
How did you hear about Willow House?
Walk and 5K to Remember
WH Family Member
WH Board Member
How did you hear about volunteer opportunities with Willow House
Why are you interested in volunteering with grieving children & teens at Willow House?
Please describe your personal and professional experiences working with children and/or teens. Please specify age and duration.
Which traits and skills do you have that
you feel will be most applicable in working with children and teens?
Have you experienced the death of a family member or close friend?
How long has it been since the death(s)? Please also describe how the person(s) in your life died and how you coped with the experience(s)
Do you have any experience in the creative arts, fitness, health or alternative therapies? If so, please describe.
Do you have any clinical certifications or degrees? If so, please list each certification and degree with year & location obtained.
Have you ever been convicted of any felonies or misdemeanors other than for minor traffic offenses?
If yes, please explain
What is your current availability?
Please list and special skills/talents you have that may be helpful to Willow House.
Any additional comments, concerns, or questions.
Willow House requires that background checks be completed for all volunteers who are working directly with Willow House children and teens in the program setting. Your signature below indicates your understanding of this volunteer policy and your agreement to your name being submitted for a background check following your completion of the training.
Signature (Type Full Name)
Volunteer Contact Record Type Id
WH Family Member Contact Record Type Id
Vol Facilitator Case Record Type Id
General Volunteer Case Record Type Id